Healthcare Provider Details

I. General information

NPI: 1760128953
Provider Name (Legal Business Name): BBHR OPCO, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/10/2022
Last Update Date: 05/10/2022
Certification Date: 05/10/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 JONES ST
BROKEN BOW OK
74728-5304
US

IV. Provider business mailing address

1805 E 15TH ST
TULSA OK
74104-4610
US

V. Phone/Fax

Practice location:
  • Phone: 580-584-6433
  • Fax:
Mailing address:
  • Phone: 918-622-4799
  • Fax: 866-218-8035

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: LARRY SNOW
Title or Position: CEO
Credential:
Phone: 918-622-4799